EFFECT OF METOCLOPRAMIDE ON GASTROESOPHAGEAL REFLUX (GER) IN INFANTS

Abstract

In adults metoclopramide increases lower esophageal sphincter pressure, shortens gastric emptying time, and is effective in the treatment of reflux esophagitis. To evaluate the efficacy of metoclopramide in infants we recorded esophageal pH continuously in 5 infants, ages 5-8 months, with GER. For each infant data were collected for 120 minutes after each of three sequential apple juice feedings. The first two feedings provided baseline control data. Immediately prior to the third feeding each infant received metoclopramide 0.2 mg/kg IM. After metoclopramide, the frequency of reflux episodes decreased from 10.2 to 9.8 (Not Significant, NS); the mean duration of reflux episodes increased from 4.5 to 6.9 minutes (NS); and the per cent of time pH was <4 increased from 33% to 42% (NS). None of the 5 infants had a 25% or greater reduction in any of the 3 measures. The radionuclide gastric emptying time was prolonged in 2 and normal in 1 of the 3 infants tested. Failure to demonstrate the effectiveness of metoclopramide may be due to a lack of efficacy of metoclopramide in infants, or to small sample size, insensitivity of the test method, inadequate dosage or route of drug administration.

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